Drake, Liza Jayne

Drake, Liza Jayne is an individual health care provider with primary practice located at W4051 County Road Nn , Elkhorn WI 53121-4338. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Drake, Liza Jayne can be contacted via phone (262) 741-3200.

Contact Information

Primary practice address
W4051 County Road Nn Elkhorn WI 53121-4338
Phone: (262) 741-3200
Fax: (262) 741-3315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7220123 Wisconsin

Profile Details

NPI number 1023035474
LBN Legal business name Drake, Liza Jayne
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Mar 2nd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023035474 NPPES
Other P00264098 RAILROAD MEDICARE
MEDICAID 40914700 RAILROAD MEDICARE

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